Case Letter
Pigmented poroma on the scalp clinically mimicking basal cell carcinoma
Masato Ishikawa
, Mikio Ohtsuka, Toshiyuki Yamamoto
Corresponding author
Department of Dermatology, Fukushima Medical University, Fukushima, Japan
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Tumor composto por pequenas células redondas, com relação núcleo‐citoplasma elevada, formando pequenos poros, que são características da diferenciação dos ductos sudoríparos (Hematoxilina & eosina, 100×).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Masato Ishikawa, Mikio Ohtsuka, Toshiyuki Yamamoto" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Masato" "apellidos" => "Ishikawa" ] 1 => array:2 [ "nombre" => "Mikio" "apellidos" => "Ohtsuka" ] 2 => array:2 [ "nombre" => "Toshiyuki" "apellidos" => "Yamamoto" ] ] ] ] ] "idiomaDefecto" => "pt" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0365059621002269" "doi" => "10.1016/j.abd.2020.08.028" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059621002269?idApp=UINPBA00008Z" ] ] "EPUB" => 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array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1572 "Ancho" => 2924 "Tamanyo" => 379011 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Clinicodermoscopic features of ABTM: (a), Telangiectatic erythematous macules on the chest and upper limbs. 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Physical examination revealed a 12-mm semi-pedunculated black nodule on the left side of the head (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Dermoscopic examination showed large blue-gray ovoid nest-like structures, irregularly dilated vessels, and erosions. Histopathological examination showed a nodular tumor extending from the epidermis into the mid-dermis (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). The tumor was composed of small round cells that had a high nucleocytoplasmic ratio, with small pores, which are features of sweat duct differentiation features of poroid differentiation into small ductal structures (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). There were no histopathological features suggestive of basal cell carcinoma (BCC). Some of the tumor cells contained melanin granules, and an increased number of melanocytes, confirmed by HMB-45 staining and MART-1 staining, was observed within the nests. Also, many melanophages were observed in the stroma. After making a diagnosis by punch biopsy, the nodule was removed under local anesthesia.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Eccrine poroma is a benign adnexal tumor mainly composed of poroid cells and often present as a reddish nodule. While eccrine poroma does not appear to have a bias for occurrence between races, pigmented variants of eccrine poroma often develop in non-white races. Pigmented eccrine poroma have been reported especially from Japan, and according to a clinicopathological analysis in Japan, among the 421 cases with pathological diagnosis of poroid cell neoplasms, 114 cases (27.1%) had melanin pigment in the tumor cells.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">As shown in the present case, pigmented eccrine poroma on the scalp can clinically mimic BCC. Previous studies have shown that pigmented eccrine poroma has dermoscopic findings of arborizing vessels and blue-gray ovoid nests, and pigmented eccrine poroma on the face was clinically similar to BCC.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> In the present case, the gross pathology are similar to those of BCC. In addition, since there were no dermoscopic findings of seborrheic keratosis or malignant melanoma, and the scalp is one of the most frequent areas where BCC occurs, the lesion was suspected to be BCC until the biopsy.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Minagawa and Koga found in their case series study that the most frequent dermoscopic structures in pigmented eccrine poromas were vascular structures such as arborizing vessels, hairpin vessels, and polymorphous vessels.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> However, the dermoscopic characteristics of other skin tumors such as globule-like structures and comedo-like openings were also found in pigmented eccrine poromas.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> One possible reason why pigmented eccrine poroma shows similar dermoscopic findings to BCC and/or seborrheic keratosis is that, as both of these tumors are classified into appendage tumors, their rough structures are similar, and they are distinguished only by pathological findings that cannot be observed by dermoscopy. Although Bombonato et al. suggested that reflectance confocal microscopy may be useful for diagnosing pigmented eccrine poroma, biopsy is still essential for the diagnosis in order to avoid misdiagnosis and overtreatment.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> In conclusion, considering the lack of established specific dermoscopic criteria for pigmented eccrine poroma, pigmented eccrine poroma on the scalp should be biopsied for histopathologic confirmation of the diagnosis.</p><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Financial support</span><p id="par0030" class="elsevierStylePara elsevierViewall">None.</p></span><span id="sec1005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect1005">Authors’ contributions</span><p id="par1025" class="elsevierStylePara elsevierViewall">Masato Ishikawa: Designed the study; performed the research and contributed to analysis and interpretation of data; wrote the initial draft of the manuscript; read and approved the final version of the manuscript.</p><p id="par1020" class="elsevierStylePara elsevierViewall">Mikio Ohtsuka: Performed the research and contributed to analysis and interpretation of data; read and approved the final version of the manuscript.</p><p id="par2020" class="elsevierStylePara elsevierViewall">Toshiyuki Yamamoto: Designed the study; assisted in the preparation of the manuscript; read and approved the final version of the manuscript.</p></span><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0025" class="elsevierStylePara elsevierViewall">None declared.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Financial support" ] 1 => array:2 [ "identificador" => "sec1005" "titulo" => "Authors’ contributions" ] 2 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2020-07-15" "fechaAceptado" => "2020-08-06" "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0030">How to cite this article: Ishikawa M, Ohtsuka M, Yamamoto T. Pigmented poroma on the scalp clinically mimicking basal cell carcinoma. An Bras Dermatol. 2021;96:793–5.</p>" ] 1 => array:2 [ "etiqueta" => "☆☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0035">The study was conducted in Department of Dermatology, Fukushima Medical University, Fukushima, Japan.</p>" ] ] "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1678 "Ancho" => 1340 "Tamanyo" => 282621 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A clinical appearance of semi-pedunculated black nodule on the left side of the head.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1309 "Ancho" => 2174 "Tamanyo" => 673947 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Histopathological examination of the lesion revealed a nodular tumor extending from the epidermis into the mid-dermis (Hematoxylin-eosin stain, original magnification, 20×).</p>" ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1271 "Ancho" => 1674 "Tamanyo" => 437691 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Detail of the histopathological examination: The tumor was composed of small round cells which had a high nucleocytoplasmic ratio, with small pores, which are features of sweat duct differentiations (Hematoxylin-eosin stain, original magnification, 100×).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pigmented eccrine poroma: a report of two cases and study with dermatoscopy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "H.W. 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Longo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5826/dpc.0603a12" "Revista" => array:6 [ "tituloSerie" => "Dermatol Pract Concept" "fecha" => "2016" "volumen" => "6" "paginaInicial" => "59" "paginaFinal" => "62" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27648386" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/03650596/0000009600000006/v2_202111180901/S0365059621002269/v2_202111180901/en/main.assets" "Apartado" => array:4 [ "identificador" => "82769" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case Letter" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/03650596/0000009600000006/v2_202111180901/S0365059621002269/v2_202111180901/en/main.pdf?idApp=UINPBA00008Z&text.app=https://clinics.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059621002269?idApp=UINPBA00008Z" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 5 | 4 | 9 |
| 2024 October | 119 | 71 | 190 |
| 2024 September | 179 | 86 | 265 |
| 2024 August | 157 | 108 | 265 |
| 2024 July | 144 | 124 | 268 |
| 2024 June | 126 | 84 | 210 |
| 2024 May | 96 | 67 | 163 |
| 2024 April | 116 | 98 | 214 |
| 2024 March | 96 | 82 | 178 |
| 2024 February | 108 | 77 | 185 |
| 2024 January | 79 | 45 | 124 |
| 2023 December | 65 | 65 | 130 |
| 2023 November | 85 | 91 | 176 |
| 2023 October | 61 | 75 | 136 |
| 2023 September | 107 | 87 | 194 |
| 2023 August | 105 | 38 | 143 |
| 2023 July | 86 | 42 | 128 |
| 2023 June | 69 | 43 | 112 |
| 2023 May | 49 | 24 | 73 |
| 2023 April | 29 | 17 | 46 |
| 2023 March | 54 | 62 | 116 |
| 2023 February | 48 | 38 | 86 |
| 2023 January | 51 | 50 | 101 |
| 2022 December | 65 | 42 | 107 |
| 2022 November | 92 | 69 | 161 |
| 2022 October | 104 | 67 | 171 |
| 2022 September | 68 | 75 | 143 |
| 2022 August | 66 | 50 | 116 |
| 2022 July | 59 | 72 | 131 |
| 2022 June | 64 | 64 | 128 |
| 2022 May | 48 | 53 | 101 |
| 2022 April | 67 | 57 | 124 |
| 2022 March | 65 | 82 | 147 |
| 2022 February | 43 | 34 | 77 |
| 2022 January | 119 | 112 | 231 |
| 2021 December | 147 | 96 | 243 |
| 2021 November | 112 | 68 | 180 |
| 2021 October | 40 | 65 | 105 |
| 2021 September | 10 | 8 | 18 |
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